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Objectives-Geriatric clinical care is a multidisciplinary assessment designed to evaluate older patients (age 65 years and above) functional ability, physical health, and cognitive wellbeing. The majority of these patients suffer from multiple chronic conditions and require special attention. Recently, hospitals utilize various artificial intelligence (AI) systems to improve care for elderly patients. The purpose of this systematic literature review is to understand the current use of AI systems, particularly machine learning (ML), in geriatric clinical care for chronic diseases. Materials and Methods-We restricted our search to eight databases, namely PubMed, WorldCat, MEDLINE, ProQuest, ScienceDirect, SpringerLink, Wiley, and ERIC, to analyze research articles published in English between January 2010 and June 2019. We focused on studies that used ML algorithms in the care of geriatrics patients with chronic conditions. Results-We identified 35 eligible studies and classified in three groups-psychological disorder (n=22), eye diseases (n=6), and others (n=7). This review identified the lack of standardized ML evaluation metrics and the need for data governance specific to health care applications. Conclusion- More studies and ML standardization tailored to health care applications are required to confirm whether ML could aid in improving geriatric clinical care.
Artificial intelligence leads the top tweeted terms are the trending industry discussions happening on Twitter by key individuals (influencers) as tracked by the platform. The steps being taken to integrate artificial intelligence (AI) into healthcare and the use of AI techniques in the detection and management of various diseases were popularly discussed in Q2. Rafael Grossmann, a surgeon and clinical innovator, shared an article on two new companies namely Anumana and Lucem Health being launched by healthcare company Mayo Clinic that will collect and analyse patient data gathered from remote monitoring devices and tools to enable early detection and diagnosis of diseases. Mayo Clinic will launch a remote monitoring platform that will enable clinicians and physicians to make quicker and better decisions with the help of the collected and analysed patient data thereby speeding up the diagnosis before symptoms appear. It will also allow patients to take more control of their health and related decisions.
Bommasani, Rishi, Hudson, Drew A., Adeli, Ehsan, Altman, Russ, Arora, Simran, von Arx, Sydney, Bernstein, Michael S., Bohg, Jeannette, Bosselut, Antoine, Brunskill, Emma, Brynjolfsson, Erik, Buch, Shyamal, Card, Dallas, Castellon, Rodrigo, Chatterji, Niladri, Chen, Annie, Creel, Kathleen, Davis, Jared Quincy, Demszky, Dora, Donahue, Chris, Doumbouya, Moussa, Durmus, Esin, Ermon, Stefano, Etchemendy, John, Ethayarajh, Kawin, Fei-Fei, Li, Finn, Chelsea, Gale, Trevor, Gillespie, Lauren, Goel, Karan, Goodman, Noah, Grossman, Shelby, Guha, Neel, Hashimoto, Tatsunori, Henderson, Peter, Hewitt, John, Ho, Daniel E., Hong, Jenny, Hsu, Kyle, Huang, Jing, Icard, Thomas, Jain, Saahil, Jurafsky, Dan, Kalluri, Pratyusha, Karamcheti, Siddharth, Keeling, Geoff, Khani, Fereshte, Khattab, Omar, Kohd, Pang Wei, Krass, Mark, Krishna, Ranjay, Kuditipudi, Rohith, Kumar, Ananya, Ladhak, Faisal, Lee, Mina, Lee, Tony, Leskovec, Jure, Levent, Isabelle, Li, Xiang Lisa, Li, Xuechen, Ma, Tengyu, Malik, Ali, Manning, Christopher D., Mirchandani, Suvir, Mitchell, Eric, Munyikwa, Zanele, Nair, Suraj, Narayan, Avanika, Narayanan, Deepak, Newman, Ben, Nie, Allen, Niebles, Juan Carlos, Nilforoshan, Hamed, Nyarko, Julian, Ogut, Giray, Orr, Laurel, Papadimitriou, Isabel, Park, Joon Sung, Piech, Chris, Portelance, Eva, Potts, Christopher, Raghunathan, Aditi, Reich, Rob, Ren, Hongyu, Rong, Frieda, Roohani, Yusuf, Ruiz, Camilo, Ryan, Jack, Ré, Christopher, Sadigh, Dorsa, Sagawa, Shiori, Santhanam, Keshav, Shih, Andy, Srinivasan, Krishnan, Tamkin, Alex, Taori, Rohan, Thomas, Armin W., Tramèr, Florian, Wang, Rose E., Wang, William, Wu, Bohan, Wu, Jiajun, Wu, Yuhuai, Xie, Sang Michael, Yasunaga, Michihiro, You, Jiaxuan, Zaharia, Matei, Zhang, Michael, Zhang, Tianyi, Zhang, Xikun, Zhang, Yuhui, Zheng, Lucia, Zhou, Kaitlyn, Liang, Percy
AI is undergoing a paradigm shift with the rise of models (e.g., BERT, DALL-E, GPT-3) that are trained on broad data at scale and are adaptable to a wide range of downstream tasks. We call these models foundation models to underscore their critically central yet incomplete character. This report provides a thorough account of the opportunities and risks of foundation models, ranging from their capabilities (e.g., language, vision, robotics, reasoning, human interaction) and technical principles(e.g., model architectures, training procedures, data, systems, security, evaluation, theory) to their applications (e.g., law, healthcare, education) and societal impact (e.g., inequity, misuse, economic and environmental impact, legal and ethical considerations). Though foundation models are based on standard deep learning and transfer learning, their scale results in new emergent capabilities,and their effectiveness across so many tasks incentivizes homogenization. Homogenization provides powerful leverage but demands caution, as the defects of the foundation model are inherited by all the adapted models downstream. Despite the impending widespread deployment of foundation models, we currently lack a clear understanding of how they work, when they fail, and what they are even capable of due to their emergent properties. To tackle these questions, we believe much of the critical research on foundation models will require deep interdisciplinary collaboration commensurate with their fundamentally sociotechnical nature.
The last decade has witnessed an experimental revolution in data science and machine learning, epitomised by deep learning methods. Indeed, many high-dimensional learning tasks previously thought to be beyond reach -- such as computer vision, playing Go, or protein folding -- are in fact feasible with appropriate computational scale. Remarkably, the essence of deep learning is built from two simple algorithmic principles: first, the notion of representation or feature learning, whereby adapted, often hierarchical, features capture the appropriate notion of regularity for each task, and second, learning by local gradient-descent type methods, typically implemented as backpropagation. While learning generic functions in high dimensions is a cursed estimation problem, most tasks of interest are not generic, and come with essential pre-defined regularities arising from the underlying low-dimensionality and structure of the physical world. This text is concerned with exposing these regularities through unified geometric principles that can be applied throughout a wide spectrum of applications. Such a 'geometric unification' endeavour, in the spirit of Felix Klein's Erlangen Program, serves a dual purpose: on one hand, it provides a common mathematical framework to study the most successful neural network architectures, such as CNNs, RNNs, GNNs, and Transformers. On the other hand, it gives a constructive procedure to incorporate prior physical knowledge into neural architectures and provide principled way to build future architectures yet to be invented.
Medical systems in general, and patient treatment decisions and outcomes in particular, are affected by bias based on gender and other demographic elements. As language models are increasingly applied to medicine, there is a growing interest in building algorithmic fairness into processes impacting patient care. Much of the work addressing this question has focused on biases encoded in language models -- statistical estimates of the relationships between concepts derived from distant reading of corpora. Building on this work, we investigate how word choices made by healthcare practitioners and language models interact with regards to bias. We identify and remove gendered language from two clinical-note datasets and describe a new debiasing procedure using BERT-based gender classifiers. We show minimal degradation in health condition classification tasks for low- to medium-levels of bias removal via data augmentation. Finally, we compare the bias semantically encoded in the language models with the bias empirically observed in health records. This work outlines an interpretable approach for using data augmentation to identify and reduce the potential for bias in natural language processing pipelines.
Explainable Artificial Intelligence (XAI) is an emerging research topic of machine learning aimed at unboxing how AI systems' black-box choices are made. This research field inspects the measures and models involved in decision-making and seeks solutions to explain them explicitly. Many of the machine learning algorithms can not manifest how and why a decision has been cast. This is particularly true of the most popular deep neural network approaches currently in use. Consequently, our confidence in AI systems can be hindered by the lack of explainability in these black-box models. The XAI becomes more and more crucial for deep learning powered applications, especially for medical and healthcare studies, although in general these deep neural networks can return an arresting dividend in performance. The insufficient explainability and transparency in most existing AI systems can be one of the major reasons that successful implementation and integration of AI tools into routine clinical practice are uncommon. In this study, we first surveyed the current progress of XAI and in particular its advances in healthcare applications. We then introduced our solutions for XAI leveraging multi-modal and multi-centre data fusion, and subsequently validated in two showcases following real clinical scenarios. Comprehensive quantitative and qualitative analyses can prove the efficacy of our proposed XAI solutions, from which we can envisage successful applications in a broader range of clinical questions.
Alizadehsani, Roohallah, Roshanzamir, Mohamad, Hussain, Sadiq, Khosravi, Abbas, Koohestani, Afsaneh, Zangooei, Mohammad Hossein, Abdar, Moloud, Beykikhoshk, Adham, Shoeibi, Afshin, Zare, Assef, Panahiazar, Maryam, Nahavandi, Saeid, Srinivasan, Dipti, Atiya, Amir F., Acharya, U. Rajendra
Understanding data and reaching valid conclusions are of paramount importance in the present era of big data. Machine learning and probability theory methods have widespread application for this purpose in different fields. One critically important yet less explored aspect is how data and model uncertainties are captured and analyzed. Proper quantification of uncertainty provides valuable information for optimal decision making. This paper reviewed related studies conducted in the last 30 years (from 1991 to 2020) in handling uncertainties in medical data using probability theory and machine learning techniques. Medical data is more prone to uncertainty due to the presence of noise in the data. So, it is very important to have clean medical data without any noise to get accurate diagnosis. The sources of noise in the medical data need to be known to address this issue. Based on the medical data obtained by the physician, diagnosis of disease, and treatment plan are prescribed. Hence, the uncertainty is growing in healthcare and there is limited knowledge to address these problems. We have little knowledge about the optimal treatment methods as there are many sources of uncertainty in medical science. Our findings indicate that there are few challenges to be addressed in handling the uncertainty in medical raw data and new models. In this work, we have summarized various methods employed to overcome this problem. Nowadays, application of novel deep learning techniques to deal such uncertainties have significantly increased.
The modelling of Electronic Health Records (EHRs) has the potential to drive more efficient allocation of healthcare resources, enabling early intervention strategies and advancing personalised healthcare. However, EHRs are challenging to model due to their realisation as noisy, multi-modal data occurring at irregular time intervals. To address their temporal nature, we treat EHRs as samples generated by a Temporal Point Process (TPP), enabling us to model what happened in an event with when it happened in a principled way. We gather and propose neural network parameterisations of TPPs, collectively referred to as Neural TPPs. We perform evaluations on synthetic EHRs as well as on a set of established benchmarks. We show that TPPs significantly outperform their non-TPP counterparts on EHRs. We also show that an assumption of many Neural TPPs, that the class distribution is conditionally independent of time, reduces performance on EHRs. Finally, our proposed attention-based Neural TPP performs favourably compared to existing models, and provides insight into how it models the EHR, an important step towards a component of clinical decision support systems.
Healthcare professionals have long envisioned using the enormous processing powers of computers to discover new facts and medical knowledge locked inside electronic health records. These vast medical archives contain time-resolved information about medical visits, tests and procedures, as well as outcomes, which together form individual patient journeys. By assessing the similarities among these journeys, it is possible to uncover clusters of common disease trajectories with shared health outcomes. The assignment of patient journeys to specific clusters may in turn serve as the basis for personalized outcome prediction and treatment selection. This procedure is a non-trivial computational problem, as it requires the comparison of patient data with multi-dimensional and multi-modal features that are captured at different times and resolutions. In this review, we provide a comprehensive overview of the tools and methods that are used in patient similarity analysis with longitudinal data and discuss its potential for improving clinical decision making.
Deep learning has demonstrated success in health risk prediction especially for patients with chronic and progressing conditions. Most existing works focus on learning disease Network (StageNet) model to extract disease stage information from patient data and integrate it into risk prediction. StageNet is enabled by (1) a stage-aware long short-term memory (LSTM) module that extracts health stage variations unsupervisedly; (2) a stage-adaptive convolutional module that incorporates stage-related progression patterns into risk prediction. We evaluate StageNet on two real-world datasets and show that StageNet outperforms state-of-the-art models in risk prediction task and patient subtyping task. Compared to the best baseline model, StageNet achieves up to 12% higher AUPRC for risk prediction task on two real-world patient datasets. StageNet also achieves over 58% higher Calinski-Harabasz score (a cluster quality metric) for a patient subtyping task.